A 66-Year-Old Woman Visits the Clinic for a Sarcoidosis Check-Up

A 66-year-old woman visits the clinic for a sarcoidosis check-up. Her lung function has deteriorated considerably over the last year, and her 12-month survival probability is less than 50%. When conversations about advance care planning and appointing a surrogate decision maker begin, the patient responds, "Why would I want to give my life away on paper? When the time comes, the Lord will take me." Which of the following is the most appropriate response?

A) "Because you have a terminal diagnosis, it is a good idea to be prepared for the reality of death."
B) "I understand that you may be scared, but this process is designed to protect you."
C) "My goal is to help your voice be heard if you lose the ability to communicate."
D) "Participating in this process will make it easier for your family to be involved in your care."
E) "You have the right to decline; I am here for you if you change your mind."